Across the country, hospitals and health systems are engaged in
what may feel like a never-ending war
against disease-causing bacteria.
In 2015, there were an estimated 687,000
healthcare-associated infections (HAIs) in U.S. acute care hospitals,
and approximately 72,000 patients
with HAIs died during their hospitalizations,
according to the Centers for Disease Control and Prevention.
COVID-19 added an additional layer of risk and uncertainty
to the health care setting – requiring many facilities
to work even harder to regain trust
and bring people back for essential services.
Healthcare leaders are asking:
What top-priority changes do we need to implement right now?
How do we ensure that practices are properly followed?
And how can we maximize our
existing plans for infection prevention?
The Targeted Assessment for Prevention Strategy— the TAP Strategy
— is a framework for quality improvement developed by the CDC.
It consists of three components:
1) Targeting prevention efforts by identifying healthcare facilities
and specific units with an excess burden of HAIs;
2) Assessing facility policies and practices to identify gaps
in infection prevention at the targeted locations; and
3) Preventing infections through tailored interventions
that address identified gaps.
The program is supported by a suite of tools and resources
uniquely designed to address the prevention of
catheter-associated urinary tract infections (CAUTI),
central line-associated bloodstream infections (CLABSI),
and Clostridioides difficile infections (CDI).
A panel of CDC experts provides technical assistance - at no cost -
to all health care organizations, including health departments,
hospital associations, health systems
and individuals using the program.
While the TAP Strategy was developed
primarily for the acute care setting
the concepts and resources may be adapted and applied
across the continuum of care.
The first component of the TAP Strategy, Target,
works by using data to identify facilities and units
with the greatest room for reducing the rate of HAIs
and achieving their hospital safety goals.
One way to identify locations to target is to generate TAP Reports
within the National Healthcare Safety Network (NHSN).
TAP Reports can be generated by group users
such as health departments and healthcare systems,
and by facility-level users.
Once health care facilities and specific units
with an excess burden of HAIs have been identified
through the TAP Report,
the assessment component can begin.
The second component – Assess –
helps hospitals and health systems identify gaps
in infection prevention in the targeted locations.
The TAP Facility Assessment Tools review infection prevention practices
in targeted locations to identify opportunities for improvement.
The assessment tools can be deployed across facilities
or within targeted units.
They are used to capture awareness and perceptions
of HAI prevention policies and practices and identify gaps.
This allows for a more customized approach to addressing the issues.
The goal is to collect as many TAP Facility Assessments as possible
by engaging front line personnel on targeted units.
The greater number of completed assessments,
the greater the ability to identify gaps
to guide improvements in care.
Assessment responses are compiled and summarized
within a TAP Feedback Report.
It is important to note that the feedback report
is distinct from NHSN TAP Reports.
The TAP Feedback Report aggregates the anonymous responses
from staff members and highlights opportunities for improvement.
The final component - Prevent -
guides partners in strengthening the implementation
of recommended interventions
to address identified gaps in infection prevention.
Feedback Reports summarize the TAP Facility assessments
and are used to identify and prioritize gaps,
helping facilities to develop and implement
targeted interventions to ultimately prevent infections.
Once priority areas have been identified,
partners can access infection prevention resources
within the TAP Implementation Guides
to help address their gaps and implement interventions.
The TAP Implementation Guides are available on the TAP website
for CAUTI, CLABSI, and CDI,
and align with the infection prevention domains
within the TAP Assessments and Feedback Reports.
Each guide contains actionable resources
including sample policies, audit tools, trainings
and comprehensive toolkits.
CDC subject matter experts are also available
for feedback and assistance.
TAP Strategy tools and technical assistance are available
to partners across the nation as we work together to improve
patient care and reduce healthcare-associated infections.
By implementing the TAP Strategy,
hospitals, health systems and other health care facilities
can work to reduce the adverse consequences
of infection and keep patients safe.
Watch the following three videos
from the TAP Strategy Learning Series
for a more in-depth review of the TAP tools and guidance
for implementing each component of the TAP Strategy.